Individual provider Active NPI

John E Vazquez, M.D.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1972502979
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036-086616 Issued in IL
Practice address
1740 W Taylor St # 3200W
Chicago, IL 60612-7232
Phone
(312) 996-4020
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-086616 IL Primary

Addresses

Primary practice location

1740 W Taylor St # 3200W
Chicago, IL 60612-7232

Mailing address

1740 W Taylor St # 3200W
Chicago, IL 60612-7232
Phone (312) 996-4020

Other identifiers 1

IdentifierTypeStateIssuer
036086616-1MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, PA, NY3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040507000957 IL Practitioner - Anesthesiology 4688663438 Reassigns benefits to 4 organizations
I20240726003891 PA Practitioner - Anesthesiology 4688663438 Reassigns benefits to 1 organization
I20240826001539 NY Practitioner - Anesthesiology 4688663438 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-086616ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Hospital CurrentSince Jun 16, 2024 Accepting new patients
Mount Sinai Community Foundation Dba Sinia Medical Group CurrentSince Feb 1, 2004 Accepting new patients
St Bernard Hospital CurrentSince May 1, 2024 Accepting new patients
KND Development 59, LLC CurrentSince Apr 10, 2012 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jan 1, 2012 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
KND Development 59, LLC CurrentSince Apr 10, 2012 Accepting new patients
Jefferson Anesthesiologist Services PC Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Feb 1, 2004 Accepting new patients
Board of Trustees of the University of Illinois Anesthesiology CurrentSince Jan 1, 2012 Accepting new patients
KND Development 59 LLC Current Accepting new patients
St Bernard Hospital Anesthesiology Current Accepting new patients
St Bernard Hospital & Health Care Center CurrentSince May 1, 2024 Accepting new patients

Locations

2544 W Montrose Ave
Chicago, IL 60618
Phone (773) 267-2622

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

326 W 64th St
Chicago, IL 60621
Phone (773) 962-3900

1740 W Taylor St
#3200W
Chicago, IL 60612
Phone (312) 996-4020

1501 S California Ave
Chicago, IL 60608
Phone (773) 257-6770

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

6130 N Sheridan Rd
Chicago, IL 60660
Phone (773) 381-1222

7732 Solutions Ctr
Chicago, IL 60677

3537 Paysphere Cir
Chicago, IL 60674

1740 W Taylor St
#3200
Chicago, IL 60612
Phone (312) 996-4021

365 E North Ave
Northlake, IL 60164
Phone (517) 273-1540

830 Washington St
Watertown, NY 13601
Phone (315) 785-4000

601 Park St
Honesdale, PA 18431
Phone (570) 253-8100

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1972502979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST # 3200W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST # 3200W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-086616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086616-1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.